VITAL SIGNS: AGING; A New Culprit in Nighttime Falls

By ERIC NAGOURNEY

Published: April 12, 2005

Doctors often hesitate to prescribe sleeping pills to people in nursing homes out of concern that the medication may lead their patients to fall and injure themselves. But a new study suggests that it is insomnia, not the pills, that may be responsible for many falls.

Writing in The Journal of the American Geriatrics Society, researchers from the University of Michigan say that doctors should more seriously consider using hypnotics, a sleeping aid, for older people who have trouble sleeping.

The lead author, Dr. Alon Y. Avidan, and his colleagues followed the health of more than 34,000 nursing home residents over a six-month period and found that those with untreated insomnia were 90 percent more likely to have fallen than the other residents. Those who had been given sleeping pills were 29 percent more likely to have fallen.

Sleep loss, the study said, can cause daytime sleepiness, mental impairment and changes in the way muscles perform. It can also slow reaction times.

These are the same problems that many doctors worry will occur if they prescribe sleeping aids, and previous studies have suggested that those drugs were contributing to falls. But the new report argues that earlier researchers did not take into account the role of insomnia itself in those falls.

But newer medicines, Dr. Avidan said, leave the system faster and do not have the same effect on mental functioning. When a older patient has insomnia, he said, a carefully chosen medication ''might not be such a bad idea.''

Dr. Avidan said he had received no financing from the pharmaceutical industry.